Individual
CHUN TONG CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11416 S MICHIGAN AVE, CHICAGO, IL 60628-4932
(773) 821-1414
(773) 821-1817
Mailing address
9680 GOLF RD, DES PLAINES, IL 60016-1522
(847) 699-0800
(847) 296-5686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036046857
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046857
—
IL
01
—
200401
MEDICARE PTAN
—
Enumeration date
10/17/2006
Last updated
11/25/2015
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